A total cavo-pulmonary connection (TCPC) or Fontan circulation is the connection of the inferior vena cava to the pulmonary artery for a single ventricle lesion. This means pulmonary blood flow is dependent on pressure difference between central venous pressure and pulmonary vascular pressures. Any increase in intrapulmonary pressure or pulmonary vascular resistance decreases pulmonary blood flow and limits cardiac output. Anaesthetic management aims to maintain cardiac output by maintaining central venous pressure with adequate preload and keeping pulmonary vascular resistance low with oxygen and mild hyperventilation.